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HomeMy WebLinkAboutPermit Electrical 2011-2-25 _El~ctrical Permit A . 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753+ FAX(S41)726-3689 ~~ 'DEPARTMENT USE ONLY (<:5Q2-']..O\\ ~OO rut no.: Dale 2-- H~ i This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is Dot started within ]80 days of issuance or if work is suspended for 180 days. LOCAL. GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION Commercial vJ. :PROPERTY OWNER Name: \).~ City: Phone: E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature: .CONTRACTOR INSTALLATION' City: Phone E-mail: ' Print name of signing supervisor: Signature of signing supervisor: ~~~ NOTICE: EXPIRE IF THE \)\IOR~ lj. THIS PERMIT SH.tILL THIS PERMIT IS NO .tI\JTHOR\Z~.?o.~~~EI: !\t3~NOONEO_ FO\' MMENl..;tU V" '- ' CO CD\rn PlN'< 180 OA'< \,,,,, 440-2584-J(9/08/CCl1l) . FEE SCHEDULE Numl)er of inspections per item ( ), Qty, Cost Total ea, cost Residential, pel' unit, service included: 1,000 sq, ft. or less (4) $134.00 $ Each additional 500 sq. ft. or portion $ 25.00 $ thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling service or feeder (2) Sen'ices or feeders: installation, alteration, relocation 200 amps or less (2) $ 81.00 $ 20 I to 400 amps (2) $ 95.00 $ 40 I to 600 amps (2) $158.00 $ 601 to 1,000 amps (2) $205.00 $ Over 1,000 amps or volts (2) $469.00 $ RecoDlle<:t only (2) $ 63.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or ATsT(I2)"J IIUN: uregoll ".:::J.VI [ , $ 63.00 $ . .1 ~._ ~_.J I " ~ t. . 201 to 400 1?~(J.: I UI"'~ uuvv......". ~ , . IT .~tinn r,pntp.r. Th, lSe r ,I $' 87.00 $ 40110 600il\T@;i(~ 952-001-001 0 tl rou~ '$126.00 $ '1iI~Q- :6oo'VOi"V '2,pJ"'" ,.,,,,.. , Over 600 a . ]. '. olts, see service"s' or fceders section above . . " _ __~ _ _ ,,, I r ",. " r, " Iltfel~~ ~I.~""" V.....II'....." \. n p Branch circ_,ll): a !tf.rq!~~4.5ff5t!.S.!/?r Pe..': panel "c ,1 a. Fee for branch circu8t~i~lP~cQa{e:Qf.lEsei:vice onfeeder fee: Each branch circuit I $ 6.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) $ 55.00 $ Each additional branch circuit $ 6.00 $ Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 $ Signal circuit or a limited-energy panel, I $ 63.00 $R.t>l) alteration, or extension (2) Eacb additional inspection: (1) $58.00 $ APPLICANT USE (A) Enter subtotal of above fees $ is. Ot> (Minimum Permit Fee SS8.00) (B) Enter 12% surcharge (.12 x [A]) $7.51. (C) Technology Fee (5% of [A]) $1.1 S TOTAL fees ancfSurcharges- (A th'rough C): - - $7< . 7( TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541.726-3753 www.ci.springfield.or.us 811-SPR2011-00308 3106 PIERCE PKWY permilcenter@ci.springfield.or.us RECEIPT NO: 2011000355 RECORD NO: 811.SPR2011.00308 DATE: 02/25/2011 lDES.CRlltnC)N: ,..,::~.' ~"T,"";",,.;i?JLi.}.~' "c.',7':~,~~", ::..;;~'i:":Acco..UNJLcobE:tk.~:""~:'.:.i';~.MOUNTcDlJE " " ,." Signal circuit(s) or Ijmited~energy panel, alteration, or extension 224-00000-426102 63.00 State of Oregon SurchargeE2.~:~ of applicable fees) 821.00000.215004 7.56 Technology fee (5% of permit total) 100-00000-425605 3.15 TOTAL DUE: 73.71 ,,-, :;"'''.fF:l: AMOUNTPAID') ~~ '. ". . i ~""..--,,,,,~ ' ..c-,..c..,:L.;;;~' _ 73.71 trJ~AXME-~f_1Xl~~~~~:~:~.55:QB~~,<cAsiIlER::~~S~A6o~~";; '..,,~: ~c'q~.Mlf.!ISiti:~'- Check SECURECOM INC 48020 TOTAL PAID: 73.71 '-